Neurological Sciences最新文献

{"title":"Safety and efficacy of arimoclomol in amyotrophic lateral sclerosis: a systematic review and meta-analysis.","authors":"Saad Masood, Muhammad Sameer Almas, Syed Saad Ul Hassan, Sameen Tahira, Muhammad Hamza Fiaz, Umm E Aimen Minhas, Hafiz Muhammad Qasim Zafar, Musa Masood","doi":"10.1007/s10072-025-08062-5","DOIUrl":"10.1007/s10072-025-08062-5","url":null,"abstract":"<p><strong>Objectives: </strong>Amyotrophic Lateral Sclerosis (ALS) is a debilitating motor neuron disorder characterized by muscle weakness, atrophy, and spasticity. This meta-analysis aims to assess the safety and efficacy of Arimoclomol in patients with ALS.</p><p><strong>Method: </strong>A comprehensive literature search was conducted on 3 databases to discover articles published up to August 2024. Included studies were randomized controlled trials (RCTs). Data was analysed using Review Manager (v5.4). Cochrane Risk of Bias-2 (RoB-2) was adopted to assess the quality of RCTs.</p><p><strong>Results: </strong>A total of 359 patients were analysed, with 239 individuals in the Arimoclomol group and 120 individuals in the placebo group. The pooled analysis of the primary outcome, change in Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) score from baseline, did not demonstrate a statistically significant difference favoring the Arimoclomol group (MD = 0.4495; 95% CI: -0.39, 1.27; p = 0.30). Similarly, secondary outcomes, including the Combined Assessment of Function and Survival (CAFS) rank score (MD = 1.00; 95% CI: -2.68, 4.67; p = 0.60), increase in transaminases (RR = 1.05; 95% CI: 0.19, 5.70; p = 0.95), mortality rate (RR = 0.86; 95% CI: 0.55, 1.34; p = 0.50), and adverse events (RR = 0.86; 95% CI: 0.55, 1.34; p = 0.50), showed no statistically significant differences between the groups.</p><p><strong>Conclusion: </strong>This study does not conclusively demonstrate that Arimoclomol has beneficial effects on ALS patients' physical functionality but shows promise for safety. Further clinical trials are needed to explore the neuroprotective effects of Arimoclomol in the treatment of ALS.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"2985-2994"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty and urinary symptoms share pathophysiological mechanisms involved in disease progression in people with multiple sclerosis.","authors":"Angelo Di Santo, Leonardo Malimpensa, Marco Canevelli, Alessandra Zampelli, Daniele Belvisi, Giorgio Leodori, Flavio Forte, Antonella Giannantoni, Giuseppe Bruno, Antonella Conte, Gina Ferrazzano","doi":"10.1007/s10072-025-08089-8","DOIUrl":"10.1007/s10072-025-08089-8","url":null,"abstract":"<p><strong>Background: </strong>Urinary symptoms represent a significant source of distress and disability in multiple sclerosis (MS), but the factors influencing their occurrence and exacerbation remain unclear. Frailty has been proposed as a measure of clinical complexity in MS and has been associated with its main phenotypic manifestations. The present study investigated the relationship between frailty and the presence and burden of urinary symptoms in MS.</p><p><strong>Materials and methods: </strong>The present study considered 149 outpatients. The presence of urinary symptoms was systematically explored. Frailty was assessed using a 40-item Frailty Index (FI). Participants with urinary symptoms underwent a urinary evaluation, including the 8-item overactive bladder questionnaire, the Urinary Incontinence Quality of Life Scale, Uroflowmetry, and Ultrasound for Postvoid Residual.</p><p><strong>Results: </strong>The mean disease duration was 13.7 years (SD 10.5), the median EDSS score was 1.5 (IQR = 0-3). Frailty was significantly associated with the presence and burden of urinary symptoms. Additionally, there was a positive correlation between the frailty index and chronological age, EDSS, disease duration, OAB, and I-QOL (all p < 0.05). In people with urinary symptoms, two multivariable logistic regression models showed that only the frailty index score was significantly associated with the Incontinence Quality of Life Scale total score and the 8-item overactive bladder questionnaire. No correlations were found between uroflowmetry data, postvoid residual, and frailty.</p><p><strong>Conclusion: </strong>Frailty is associated with the presence and burden of disability due to urinary symptoms. Frailty possibly affects the pathophysiological mechanisms of MS involved in the development and worsening of urinary symptoms.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"3175-3182"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nighttime systolic blood pressure reduction rate and periventricular white matter hyperintensity were associated with cognitive function in Parkinson's disease.","authors":"Lanlan Chen, Tingting Qiao, Cancan Ma, Chunfeng Liu, Yingzhu Chen, Hongying Zhang, Yao Xu","doi":"10.1007/s10072-025-08029-6","DOIUrl":"10.1007/s10072-025-08029-6","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the relationship between nighttime systolic blood pressure (NSBP) reduction rate, white matter hyperintensity (WMH), and cognitive function in Parkinson's disease (PD) patients.</p><p><strong>Methods: </strong>All PD participants underwent 24-hour ambulatory blood pressure monitor and MRI, with the volumes of WMHs quantified. Participants were categorized into normal dipping and non-dipping groups based on dipping patterns, as well as dementia and non-dementia groups according to a Montreal Cognitive Assessment (MoCA) score of less than 20. Multivariate linear regression analysis was performed to identify independent risk factors for cognitive function.</p><p><strong>Results: </strong>Compared to normal dippers (n = 13), non-dippers (n = 39) showed significantly lower MoCA scores, higher volumes of periventricular WMH, ratios of periventricular WMH to white matter (WM), and ratios of deep WMH to WM (P = 0.027; 0.015; 0.011; 0.023). Moreover, the ratios of juxtaventricular WMH to WM, periventricular WMH to WM, and deep WMH to WM in the dementia group were significantly higher than those in the non-dementia group (P = 0.003; 0.001; 0.011). Regression analysis revealed that education and NSBP reduction rate were independent protective factors (OR = 4.107, P < 0.001; OR = 2.062, P = 0.045), whereas ratio of periventricular WMH to WM was an independent risk factor (OR= -2.640; P = 0.011) for cognitive function in PD patients.</p><p><strong>Conclusions: </strong>NSBP reduction rate and ratio of periventricular WMH to periventricular WM were associated with cognitive function in PD patients. Reduced NSBP reduction may contribute to the development of WMH and consequent cognitive impairment in PD patients.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"3107-3115"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease presenting with meningoencephalitis: a case report.","authors":"Wang You, Yong Liu, Gong Chen, Chen Yangmei, Xu Tao","doi":"10.1007/s10072-025-08088-9","DOIUrl":"10.1007/s10072-025-08088-9","url":null,"abstract":"","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"3329-3331"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccines for Alzheimer's disease: a brief scoping review.","authors":"Ibrahim Serag, Mohamed Abouzid, Mostafa Hossam El Din Moawad, Jaber H Jaradat, Mohamed Hendawy, Nada Ibrahim Hendi, Ibraheem M Alkhawaldeh, Judy Ahmed Abdullah, Mona Mahmoud Elsakka, Muneeb Ahmad Muneer, Marwa Aboelhassan Elnagar, Mohamed Adel Fakher, Aya J Elkenani, Abdallah Abbas","doi":"10.1007/s10072-025-08073-2","DOIUrl":"10.1007/s10072-025-08073-2","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer's disease (AD) is a neurodegenerative disorder and the most common cause of dementia among older adults. Existing treatments-such as cholinesterase inhibitors, N-methyl-D-aspartate receptor antagonists, and monoclonal antibodies targeting amyloid beta-can improve functional and neuropsychiatric outcomes but fail to prevent disease onset, halt progression, or adequately reduce amyloid-beta burden. Consequently, research efforts have shifted to primary prevention through immunization, although the efficacy of these strategies remains uncertain. This review explores the efficacy, safety, and adverse events of current immunotherapies for AD and discusses future research and clinical implications.</p><p><strong>Methods: </strong>A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-SR) checklist. A systematic search was carried out using PubMed, Scopus, and Web of Science.</p><p><strong>Results: </strong>A total of 145 studies were included. Preclinical research often employed transgenic mouse models to investigate AD pathology and vaccine benefits, while Phase I and II clinical trials centered on safety and preliminary efficacy in humans. Most studies were conducted in the USA, China, and Japan, highlighting these countries' strong clinical trial infrastructure. Vaccination frequently reduced amyloid-beta or tau pathology in preclinical settings, although cognitive outcomes were inconsistent. Clinical trials primarily focused on safety and immune response, with newer vaccines such as ABvac40 demonstrating encouraging results and minimal adverse events.</p><p><strong>Conclusion: </strong>Although AD vaccines show promise in preclinical settings, longer and more comprehensive clinical trials are necessary to determine their long-term efficacy and safety. Standardized protocols and efforts to reduce regional disparities in research would facilitate better comparability and generalizability of findings, thereby guiding the future development of effective immunotherapies for Alzheimer's disease.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"2925-2950"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NfL as a biomarker in ATTRv amyloidosis: potential and limitations.","authors":"Massimo Russo, M De Luca, L Gentile, F D'Arma, A Pugliese, V Macaione, F Polito, L Licitri, A Cafarchio, M H Aguennouz, C Rodolico, A Mazzeo","doi":"10.1007/s10072-025-08110-0","DOIUrl":"10.1007/s10072-025-08110-0","url":null,"abstract":"<p><p>Hereditary transthyretin amyloidosis (ATTRv) presents unique challenges in diagnosis and monitoring due to its phenotypic and genetic heterogeneity. This study evaluates the utility of serum neurofilaments light chains (NfL) as a reliable biomarker of disease activity in patients carrying different pathogenic TTR variants. Twenty-eight ATTRv patients carrying the following mutations (p.Phe84Leu, p.Glu109Gln, p.Thr69Ala, p.Val50Met) as well as 8 carriers and 27 healthy control subjects underwent extensive examination, including serum NfL measurement, neuropathy impairment score for the lower limb (NIS-LL), compound autonomic dysfunction test (CADT), and polyneuropathy disability (PND) scores, at T0, T6 and T12. The study not only confirms the previously established correlation between serum NfL concentrations and disease severity scales but also extends these observations to the mutations reported here. Furthermore, the research highlights the potential of serum NfLs as discriminators between presymptomatic carriers and symptomatic patients, emphasizing their utility in predicting disease onset and facilitating timely intervention.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"3263-3269"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efgartigimod improves non-AChR generalized Myasthenia Gravis: a real world experience.","authors":"Carlo Antozzi, Rita Frangiamore, Elena Rinaldi, Fiammetta Vanoli, Francesca Andreetta, Eleonora Giacopuzzi Grigoli, Emilio Ciusani, Silvia Bonanno, Lorenzo Maggi, Renato Mantegazza","doi":"10.1007/s10072-025-08096-9","DOIUrl":"10.1007/s10072-025-08096-9","url":null,"abstract":"<p><strong>Introduction: </strong>The neonatal Fc receptor (FcRn) inhibitor Efgartigimod (EFG) has been approved for treatment of generalized Myasthenia Gravis (gMG) with anti-AChR antibodies. Information on the effect of EFG in non-AChR MG is limited. We investigated the efficacy of EFG in non-AChR gMG along a clinical follow-up of 2 years.</p><p><strong>Methods: </strong>We treated 13 patients with gMG without anti-AChR antibodies: 5 MuSK+, 2 LRP4 + and 6 triple-negative (confirmed by live CBA). EFG was administered according to the GENERATIVE protocol (consisting of a Fixed period of 2 treatment cycles of 4 infusions at weekly intervals, followed by a Flexible period during which EFG was given in case of initial worsening) starting from November 2021. Outcomes were evaluated by means of the MG-ADL, QMG, MGC and MGQoL15r scales.</p><p><strong>Results: </strong>The mean follow-up was 21 ± 5.3 months. Meaningful improvement was observed with the clinical scores adopted. The number of cycles/year was 3.92 ± 0.9. The interval between cycles was 10.1 ± 3.6 weeks. MG-ADL improvement of at least 5 points was recorded in 58% of cycles. 46% of patients required hospitalization during the two years before treament with EFG and 70% plasmaexchange/IVIG; during EFG none of the patients was hospitalized or required immunomodulation. No major side effects or infusion related reactions occurred.</p><p><strong>Conclusion: </strong>EFG was effective in non-AChR gMG and modified significantly the course of the disease. Our experience strengthens the role of FcRn inhibition as a new therapeutic tool for MG without anti-AChR antibodies.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"3271-3279"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aging, frailty, and their effects on motor performance: evidence from kinematic analysis.","authors":"Martina De Riggi, Giulia Paparella, Antonio Cannavacciuolo, Martina Salzillo, Filippo Nuti, Ludovica Quarta, Daniele Birreci, Davide Costa, Luca Angelini, Marco Canevelli, Matteo Bologna","doi":"10.1007/s10072-025-08092-z","DOIUrl":"10.1007/s10072-025-08092-z","url":null,"abstract":"<p><strong>Introduction: </strong>Aging is commonly linked to motor impairment. However, the relationship between motor performance across age groups and frailty remains unexplored through objective analysis.</p><p><strong>Objective: </strong>To kinematically evaluate motor performance in older and younger adults and investigate its potential connection to frailty.</p><p><strong>Methods: </strong>We included 65 healthy subjects (40 females, age range 46-83 years). We used kinematic techniques to study finger-tapping and measure several movement parameters, i.e., number of movements, movement rhythm, amplitude and velocity, as well as progressive reduction in amplitude and velocity during movement repetition (sequence effect). The frailty status was evaluated using a 40-item Frailty Index (FI). We also evaluated cognitive functions, using the Mini Mental State Examination (MMSE) and the Frontal Assessment Battery (FAB). We tested possible relationships between clinical and kinematic data using Spearman's correlation.</p><p><strong>Results: </strong>A key finding was a significant difference in movement velocity between younger and older adults, with the latter exhibiting lower values (P = 0.014). Accordingly, age significantly correlated with movement velocity (ρ = -0.335, P = 0.037). Among older adults, movement velocity was also found to correlate with frailty (ρr = -0.297, P = 0.033), thus indicating that greater frailty is associated with more impaired motor performance.</p><p><strong>Conclusions: </strong>The relationship between the age-related slowed movement execution and frailty suggests that motor performance may serve as a sensitive indicator of physical vulnerability in aging populations.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"3097-3106"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress hyperglycemia indexes and early neurological deterioration in spontaneous intracerebral hemorrhage.","authors":"Carmelo Tiberio Currò, Federica Ferrari, Giovanni Merlino, Stefan Moraru, Francesco Bax, Fedra Kuris, Lorenzo Nesi, Mariarosaria Valente, Elena Ballante, Nicola d'Altilia, Cristina Rascunà, Andrea Morotti, Federico Mazzacane, Anna Maria Cavallini","doi":"10.1007/s10072-025-08097-8","DOIUrl":"10.1007/s10072-025-08097-8","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the relationship of early neurological deterioration (END) with admission glycemia (aG) and new stress hyperglycemia indexes in spontaneous intracerebral hemorrhage (ICH) patients.</p><p><strong>Methods: </strong>The present retrospective study included 171 ICH patients from two stroke centers. END was defined as an increase ≥ 4 points in National Institutes of Health Stroke Scale and/or a decrease ≥ 2 points in Glasgow Coma Scale within 72 hours from admission. The included stress hyperglycemia indexes were glycemic gap (GGAP), stress hyperglycemia ratio (SHR), and glucose-glycated hemoglobin ratio. GGAP was calculated as aG - 28,7*glycated hemoglobin + 46,7; SHR as aG / (28,7*glycated hemoglobin - 46,7); Glucose-glycated hemoglobin ratio as aG / glycated hemoglobin. We performed univariate and multivariate analyses for END. The receiver operating characteristic curves were built for END-related glycemic measures; area under curves (AUC) were calculated and compared. The optimized threshold values were calculated, and significant glycemic measures were dichotomized. Univariate and multivariate analyses were performed for the dichotomized measures.</p><p><strong>Results: </strong>END was present in 21 patients (12.3%) and was significantly associated with GGAP, SHR and glucose-glycated hemoglobin ratio, but not with aG. The AUC of the three stress hyperglycemia indexes did not differ significantly. The optimized cutoffs were 35.68 (sensitivity 0.47, specificity 0.81), 1.15 (sensitivity 0.62, specificity 0.68), and 26.67(sensitivity 0.43, specificity 0.80) for GGAP, SHR, and glucose-glycated hemoglobin ratio respectively. END was also associated with all stress hyperglycemia indexes expressed as categorical variables.</p><p><strong>Conclusion: </strong>GGAP, SHR, and glucose-glycated hemoglobin ratio were predictors of END in ICH patients.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"3135-3145"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards a new Value-based scenario for the management of dementia in Italy: a SINdem delphi consensus study.","authors":"Camillo Marra, Flavia Beccia, Paolo Caffarra, Federica L'Abbate, Federica Agosta, Alberto Benussi, Laura Bonanni, Amalia C Bruni, Giuseppe Bruno, Stefano F Cappa, Chiara Cerami, Francesco Di Lorenzo, Carlo Ferrarese, Daniela Galimberti, Biancamaria Guarnieri, Claudio Mariani, Benedetta Nacmias, Leonardo Pantoni, Tommaso Piccoli, Daniela Perani, Innocenzo Rainero, Fabrizio Tagliavini, Annalena Venneri, Stefania Boccia, Annachiara Cagnin, Giovanna Elisa Calabrò, Marco Bozzali","doi":"10.1007/s10072-025-08143-5","DOIUrl":"10.1007/s10072-025-08143-5","url":null,"abstract":"<p><p>This national expert-based Delphi-consensus aims at formulating recommendations on the management of dementia care in Italy. This effort seems important and timely given in light of a new scenario arising from a new biological definition of Alzheimer's disease (AD) and the availability of disease-modifying treatments (DMTs).</p><p><strong>Methods: </strong>the Steering Committee of the Italian Neurological Society for dementia (SINdem) created appropriate statements. Invited SINdem experts were requested to vote on the statements according to a modified three-round Delphi method. Only those statements reaching Grade A (full agreement ≥ 75%) or B (overall agreement ≥ 80% and full disagreement < 5%) were included in the final document. Round answers' consistency was graded using the Cohen's k and within-class correlation coefficient.</p><p><strong>Results: </strong>Forty-six experts voted on 20 statements, which focused on the following aspects: i) organization of care services from early diagnosis to the management of advanced clinical stages; ii) access to biomarkers for a biological diagnosis of AD; iii) requirements necessary for the administration of DMTs; iv) main actors and pathways for the management of patients suffering from cognitive disorders. At the end of the process, 4 statements (20%) received a Grade A consensus, while 16 (80%) reached a Grade B consensus. Although the responses reflect heterogeneity among Italian regions, there was a fair degree of consistency for all statements.</p><p><strong>Conclusion: </strong>The high strength of this expert-based Delphi-consensus may offer guidance for improving the patient's journey of individuals with cognitive decline from a biological diagnosis to DMTs administration and may possibly offer hints to the Health Systems on dementia.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"2913-2923"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}